EP1850288A2 - Verfahren und Vorrichtung zur Überprüfung von Versicherungspolicen - Google Patents

Verfahren und Vorrichtung zur Überprüfung von Versicherungspolicen Download PDF

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Publication number
EP1850288A2
EP1850288A2 EP07008450A EP07008450A EP1850288A2 EP 1850288 A2 EP1850288 A2 EP 1850288A2 EP 07008450 A EP07008450 A EP 07008450A EP 07008450 A EP07008450 A EP 07008450A EP 1850288 A2 EP1850288 A2 EP 1850288A2
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EP
European Patent Office
Prior art keywords
revision
policy data
legally
policy
revisions
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Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
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EP07008450A
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English (en)
French (fr)
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EP1850288A3 (de
Inventor
Clark Allan Heydon
Kenneth William Branson
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Guidewire Software Inc
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Guidewire Software Inc
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Publication of EP1850288A2 publication Critical patent/EP1850288A2/de
Publication of EP1850288A3 publication Critical patent/EP1850288A3/de
Withdrawn legal-status Critical Current

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    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06Q—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES; SYSTEMS OR METHODS SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES, NOT OTHERWISE PROVIDED FOR
    • G06Q40/00—Finance; Insurance; Tax strategies; Processing of corporate or income taxes
    • G06Q40/08—Insurance

Definitions

  • This invention relates generally to insurance products.
  • Insurance policies are known in the art and comprise complex agreements that specify items to be afforded coverage with respect to particular perils.
  • An insurance policy almost invariably extends coverage for a pre-determined period, during which claims can be made for covered losses.
  • insurance policies rely heavily on accurate treatment of time periods.
  • the policy period is usually one year, and policies are generally renewed on an annual basis, with a new policy period starting at the end of the previous period.
  • changes to a policy coincide with the annual renewal, but in many cases changes occur mid-term.
  • the effective date of a policy change may not coincide with the end of the policy period.
  • the effective date of a policy change is the date on which the change becomes legally effective and can comprise a present, retroactive, or future date.
  • the change date of a policy change is the date on which the change was actually made. Changes to a policy, whether at renewal or mid-term, trigger a series of follow-on computations, the most important of which is often a recalculation of the total cost of the policy to reflect the changes and the amount of time remaining in the policy period.
  • insurers For purposes of evaluating a premium, insurers need to know what coverages were, are, or will be in effect for what durations. In addition, for purposes of evaluating a claim, insurers need to be able to determine what coverages were in effect as of the date of the claim.
  • OOSE out-of-sequence endorsements
  • an endorsement which comprises a change to an existing policy
  • OOSE out-of-sequence endorsements
  • any existing revisions that are legally subsequent to the OOSE must often be re-evaluated and/or re-priced based on the terms introduced by the OOSE.
  • FIG. 1 comprises a flow diagram as configured in accordance with various embodiments of the invention
  • FIG. 2 comprises a flow diagram as configured in accordance with various embodiments of the invention.
  • FIG. 3 comprises a flow diagram as configured in accordance with various embodiments of the invention
  • FIG. 4 comprises an illustrative schematic as configured in accordance with various embodiments of the invention.
  • FIG. 5 comprises an illustrative schematic as configured in accordance with various embodiments of the invention.
  • FIG. 6 comprises an illustrative schematic as configured in accordance with various embodiments of the invention.
  • FIG. 7 comprises an illustrative screen shot as configured in accordance with various embodiments of the invention.
  • FIG. 8 comprises an illustrative screen shot as configured in accordance with various embodiments of the invention.
  • FIG. 9 comprises an illustrative screen shot as configured in accordance with various embodiments of the invention.
  • FIG. 10 comprises an illustrative schematic as configured in accordance with various embodiments of the invention.
  • FIG. 11 comprises an illustrative schematic as configured in accordance with various embodiments of the invention.
  • FIG. 12 comprises an illustrative screen shot as configured in accordance with various embodiments of the invention.
  • FIG. 13 comprises a block diagram as configured in accordance with various embodiments of the invention.
  • an insurance policy is stored as a plurality of discrete temporally-sequential policy data revisions, wherein each revision incorporates information from temporally prior revisions covering an effective date range of the revision.
  • a legally binding revision for a first given date is then determined by identifying all policy data revisions effective on the first given date and choosing a most temporally recent policy data revision temporally prior to a second given date.
  • each policy data revision may have a corresponding change date and a corresponding legally effective date stored therewith. The change dates and the legally effective dates may then be used to facilitate determination of a present liability.
  • the policy data revisions may be queried in terms of the change date and the legally effective date to determine a status of the insurance policy as of the queried-for dates.
  • a new policy data revision is temporally subsequent as compared to a first policy data revision and also comprises a legally effective date range preceding at least in part an effective date range of the first policy data revision
  • legally non-overlapping policy data revisions are created for each legally overlapping effective date range as exists between the new policy data revision and all temporally preceding policy data revisions.
  • Each newly-created legally non-overlapping policy data revision comprises changes introduced by the new policy data revision and at least one temporally preceding policy data revision.
  • the new policy data revision may comprise a bound revision or may comprise an unbound draft revision.
  • differences introduced by the new policy data revision can then be determined, with the differences being optionally identified for a user.
  • the differences introduced by the new policy data revision can then be applied to the newly-created legally non-overlapping policy data revisions to create merged legally non-overlapping policy data revisions.
  • the application of those differences creates conflicting insurance policy terms, the user may be provided with an opportunity to resolve the conflicting insurance policy terms, or the conflicting insurance policy terms may be automatically resolved.
  • an insurance policy period may be divided up into time intervals with multiple policy revisions corresponding to each time interval.
  • insurance providers may readily track insurance policy revisions and accurately process claims based on the effective dates and change dates of the revisions. Further, revisions occurring out of sequence will not result in the loss of information about the actual time of the change, and will instead preserve both the effective date and change date.
  • an illustrative enabling method 100 will store 101 an insurance policy as a plurality of discrete temporally-sequential policy data revisions, wherein each revision incorporates information from temporally prior revisions covering an effective date range of the revision. More particularly, each revision may incorporate information from a temporally prior revision having legally effective date ranges that overlap at least in part the legally effective date range of that revision.
  • a legally binding revision for a first given date is then determined 102 by identifying all policy data revisions effective on the first given date and choosing a most temporally recent policy data revision temporally prior to a second given date.
  • the second given date may be the same as the first given date or the second given date may be different from the first given date.
  • the insurance policy may comprise supplemental policy-specific data.
  • an insurance product model may be provided, wherein the insurance product model may be substantively interpreted to thereby facilitate obtaining the supplemental policy-specific data.
  • the interested reader can learn more regarding insurance product models by reference to Insurance Product Model-Based Apparatus and Method as filed on February 7, 2006 and having application number 11/349,456, the contents of which are fully incorporated herein by this reference.
  • Each policy data revision may have a corresponding change date and a corresponding legally effective date stored therewith.
  • the legally effective date is the date on which that revision becomes effective. This effective date does not necessarily correspond to the change date, which is the date on which the revision was made in actual time. For example, it is common for changes to a policy to be made retroactively, where the effective date is earlier than the change date.
  • a car may be purchased, with the owner adding the car to the owner's insurance policy several days after the purchase date, with coverage extending retroactively back to the purchase date. Therefore, the effective date of the addition would be the purchase date.
  • the change dates and the legally effectives dates can then be used to facilitate determination of a present liability, such as, for example, with respect to a claim for coverage.
  • FIG. 4 an illustrative schematic of an insurance policy having discrete policy data revisions is shown.
  • a series of draft policy revisions are listed under the Drafts heading 401, and the bound versions of those policy revisions are shown under the Legally-Binding Revisions heading 402.
  • the draft revisions are revisions that are not effective and are therefore "unbound.”
  • the x-axis 403 shows time in terms of effective dates for the resulting bound policy revisions. Each revision is displayed showing the period that the revision covers at the time the revision is created (starting at the revision effective date and usually ending at the policy period expiration date).
  • the y-axis 404 shows time in terms of the change date, which is the actual time that the actions take place in the system (i.e., drafts are shown in the order in which they are begun and bound revisions are shown in the order in which they are bound, which is usually the same order).
  • the bars labeled as A 405, B 406, C 407 and D 408 each represent a policy data revision.
  • A represents a submission of a newly created policy
  • B, C, and D represent policy changes.
  • A may represent the submission of an auto policy 409 on 12/1/04, effective 1/1/O5.
  • revision B the policy change 410 increased the liability limit on 6/1/05, effective 7/1 /05 and in revision C the policy change 411 lowers the default collision deductible on 9/1/05, effective 10/1/05.
  • revision D the policy change 412 adds a new vehicle on 12/1/05, effective 4/1/05.
  • revision D is an out-of-sequence endorsement, or OOSE, because its effective date is earlier than temporally preceding revisions B and C.
  • a legally binding revision for a given date can then be determined 102 by first identifying all policy data revisions effective on that date.
  • a given date of 8/15/05 413 is located along the effective time x-axis 403, and it can be seen that the policy data revisions effective on that date are revisions A 405, B 406 and D 408.
  • the legally binding revision is determined by choosing a most temporally recent policy data revision that is temporally prior to a second given date (wherein the second given date is specified by the user).
  • the revision is found in FIG. 4 by following the 8/15/05 413 line down from the x-axis and locating the revision having a change date that is temporally prior to the date of 1/1/06 on the actual time y-axis 404. Therefore, the legally binding revision for 8/15/05 when looking at the policy as of 1/1/06 is revision D 408, as revision D has a change date of 12/1/05, which is the most temporally recent policy data revision that is temporally prior to 1/1/06. It should be noted that this representation may be used to answer many other questions. For example, a user can determine the status of a policy based on a specific date by looking for the most temporally recent revision with a change date prior to that specific date (effectively drawing the line starting partway up the y-axis).
  • the user specifies an effective date for the change.
  • This effective date is used to look up the temporally most recent legally binding revision as of that effective date as described above.
  • This legally binding revision is used as the basis for the new revision, that is, the draft new revision is initialized to be a copy of the most temporally recent legally binding revision.
  • the draft revision D 408 is initialized as a copy of revision A 405 because A 405 is the most temporally recent legally binding revision. It should also be noted that the changes later introduced in revisions B 406 and C 407 are not incorporated into the revision D 408 as it is initially created, since those changes became effective after D's effective date.
  • revision D 408 Any changes made to revision D 408 apply to the rest of the policy period. However, these changes must be merged together with any changes made to the same policy with later effective dates. In FIG. 4, for example, the addition of the vehicle in revision D 408 effective 4/1/05 applies through the end of the policy period, but the subsequent changes made to B 406 and C 407 must also be incorporated into D 408 for legal and pricing purposes.
  • one embodiment of the policy revisioning method automatically breaks D 408 into multiple temporally non-overlapping segments, with each of these segments representing a complete policy revision. There is one segment for each temporally preceding bound revision. In the example of FIG.
  • first segment that includes the changes made to revision A 405 (the addition of the new vehicle), a second segment that merges those changes with the changes incorporated in revision B 406 (the increased liability limit), and a third segment that merges those changes with the changes incorporated in revision C 407 (the decrease in the default collision deductible).
  • the revision is divided into independent segments to reflect and preserve the legal differences for each segment and aids a user in determining the status of the policy at a particular point in time. For example, in the event of a claim whose time period falls in the second or third segment, the liability limit will be higher than if the claim had fallen in the first segment's time period. The process of creating the segments will be further discussed below.
  • a new policy data revision is 103 temporally subsequent as compared to a first policy data revision and also comprises a legally effective date range preceding at least in part an effective date range of the first policy data revision (i.e., an out-of-sequence endorsement or OOSE)
  • legally non-overlapping policy data revisions are created 104 for each legally overlapping effective date range as exists between the new policy data revision and all temporally preceding policy data revisions.
  • Each newly-created legally non-overlapping policy data revision comprises changes introduced by the new policy data revision and at least one temporally preceding policy data revision.
  • an OOSE is represented by revision D 408.
  • D 408 is a new revision that is temporally subsequent (i.e., along the actual time y-axis 404) to policy revisions B 406 and C 407, and also comprises a legally effective date range (i.e., along the effective time x-axis 403) preceding at least in part the effective date ranges of policy revisions B 406 and C 407. Therefore, legally non-overlapping policy data revisions are created for each legally overlapping period as exists between the new policy data revision and all temporally preceding policy data revisions. As shown in FIG. 5, revision D 408 has been divided into segments D1 501, D2 502, and D3 503 that are now legally non-overlapping policy data revisions.
  • D 408 was divided into the segments based on where D 408 legally overlaps the temporally preceding policy data revisions. Therefore, D1 501 spans from D's effective date to the initial effective date of B, D2 502 spans from the initial effective date of B to the initial effective date of C, and D3 503 spans from the initial effective date of C to the final effective date of the policy.
  • This first step of creating the non-overlapping policy data revisions is shown in FIG. 6 and denoted by circled number 1 601.
  • D1 501 represents the changes made by the new revision D 408 to revision A 405
  • D2 502 is created by copying revision B 406
  • D3 503 is created by copying revision C 407.
  • the system may then determine 105 the differences introduced by the new policy data revision.
  • the system determines the differences introduced by the new policy data revision as compared to a temporally prior revision.
  • This second step denoted by circled number 2 602 in FIG. 6, determines the changes made by the new OOSE revision D 408 as compared to revision A 405, with the differences of the OOSE represented as ⁇ 1 605.
  • at least one of the differences introduced by the new revision may also be identified 106 for a user.
  • a policy revision is represented by a hierarchy of policy revision elements. These elements, such as coverages, coverage terms, exposure units, and policy lines, each have a unique identifier that remains the same across revisions of the same policy. These identifiers are called revision-independent IDs, or RIIDs. When a new element (such as a coverage) is created and added to a policy, a unique RIID is selected and assigned to it.
  • Collecting the differences ⁇ 1 between revision A and revision D is accomplished by using RIIDs to match up like elements between the two revisions.
  • Three kinds of changes are identified: additions of new elements, removals of existing elements, and changes to field values of existing elements.
  • the invention recursively looks for field changes to those elements, as well as additions or removals of sub-entities it contains. Since not all field changes are relevant to the user (such as internal fields relevant only to the implementation), certain field differences may be excluded from the computation.
  • the system may automatically apply 107 the differences introduced by the new policy data revision into the newly-created legally non-overlapping policy data revisions, to create merged legally non-overlapping policy data revisions.
  • This third step denoted by circled number 3 603 in FIG. 6, involves applying the differences ⁇ 1 605 to both D2 502 and D3 503, thereby merging the OOSE differences forward to those legally subsequent revisions being superseded by revisions D2 502 and D3 503.
  • each segment now represents the merging of the differences between the base revision (A 405) and the new revision (D 408), or ⁇ 1 605, and the effect of the overlapping revision it supersedes (B 406 as to D2 502 and C 407 as to D3 503).
  • D 1 501 revision represents the changes to revision A 405, while the D2 502 revision incorporates the new changes of revision D 408 and the effect of revision B 406.
  • the D3 503 revision incorporates the new changes of revision D 408 and the effect of revision C 407.
  • ⁇ 1 would be the addition of the new car, so D1 represents the addition of the new car.
  • D2 represents B + ⁇ 1 , therefore the higher limit of revision B is applied to the new car.
  • D3 represents C + ⁇ 1 , therefore the lower deductible of revision C is applied to the new car.
  • automatically applying the differences introduced by the new policy data revision may further comprise determining 108 if applying the differences introduced by the new policy data revision into the newly-created legally non-overlapping policy data revisions creates conflicting insurance policy terms.
  • any incompatible changes, or so-called merge conflicts may be detected.
  • Merge conflicts are detected by comparing the differences ⁇ 1 to the changes that were made to produce the bound revision with the later effective date. For example, and referring now to FIG. 6, before applying the differences ⁇ 1 to D2, the differences ⁇ B 608 must be collected. Similarly, before applying the differences ⁇ 1 to D3, the differences ⁇ C 609 must be collected. Any merge conflicts are then detected by comparing the differences ⁇ 1 to the differences collected ( ⁇ B and ⁇ C ) by matching up changes to elements with the same RIID.
  • the liability limit had a value of $100 in revision A, was changed to a value of $200 in B, but was changed to a value of $300 in D
  • the change from $100 to $300 in ⁇ 1 conflicts with the change $100 to $200 in ⁇ B .
  • the conflict can be detected by noticing that the same field was changed to different values in the two revisions. Once the conflicts are detected, the conflicts may then be resolved, as further described below.
  • the product model logic will cause the coverage to be added automatically; if not, the policy will fail to validate until the user has manually added the coverage. In either case, there will be an additional change to the policy revision that was present in neither of the sets of changes that contributed to the merge process.
  • the differences ⁇ 2 606 and ⁇ 3 607 can then be displayed along with ⁇ 1 605 so that a user can view the differences applied by the OOSE.
  • conflicting insurance policy terms may then be identified 109 for a user.
  • a merge conflict is created by applying the differences introduced by the new policy data revision into the newly-created legally non-overlapping policy data revisions, a user may be provided 201 with an opportunity to resolve the conflicting insurance policy terms.
  • FIG. 7 a screen shot 700 is displayed allowing a user to select the merge rules 701 that should be applied for an OOSE. In this example, the display asks the user "How should merge conflicts be resolved?" 702.
  • the user may elect to resolve the merge conflict by having the change introduced by the OOSE overwrite any future version 703, or the user may select to retain the terms specified by the future (legally subsequent) version 704. The user may then select to "Recalculate merge” 705 once making the merge rule selection. If the user has chosen to overwrite any future version 703, the merge conflict is resolved by setting the value on the superseding revision to the value from ⁇ 1 . If the user has instead chosen to retain the terms specify by the future version 704, the value on the superseding revision is left unchanged. (It should be noted and understood at the outset that these screen shots are illustrative embodiments of the methods used for policy revisioning. As such, it will be clearly understood that the options, functions, arrangements, and displays of these teachings are not limited to those specifically shown in these embodiments.)
  • the conflicting insurance policy terms may be automatically resolved 202.
  • Automatically resolving the conflicting insurance policy terms may optionally comprise accepting the terms introduced by the new policy data revision. Therefore, the default resolution of any conflict would be to accept the most temporally recent change as introduced by the new policy data revision. Referring again to the revisions displayed in FIG. 6, for example, any conflicting terms detected by the merge of ⁇ 1 into D2 and D3 (step 3 603) would be resolved in favor of the terms introduced by revision D 408.
  • the automatic resolution of the conflicting insurance policy terms may comprise accepting the terms defined by the revision that is legally subsequent to the new policy data revisions. Therefore, in FIG. 6, any conflicting terms detected by the merge of ⁇ 1 into D2 and D3 (step 3 603) would be resolved in favor of the terms introduced by the legally subsequent revisions B 406 and C 407, respectively.
  • the conflicting insurance policy terms may be automatically resolved according to a configurable method.
  • the configurable method may include a series of parameters and/or default or predefined rules that will govern the resolution of merge conflicts.
  • the configurable method may vary according to the needs, requirements, and desires of a given system administrator and/or user base. As an example, the configuration may require that any conflicts relating to limits or deductibles be resolved by accepting the higher limit or deductible amount.
  • an illustrative screen shot 800 displays for a user a list of changes for a given insurance policy.
  • the first set of changes 801 relate to a vehicle change for a 1997 Toyota Corolla, with the relevant changes listed below.
  • the changes resulting from the OOSE revision are listed in bold and the effective date of each change is listed in brackets.
  • the legally subsequent revision changed the license plate to 2QWS945.
  • the merge conflict 803 was resolved by having the OOSE revision overwrite the legally subsequent (but temporally preceding) revision.
  • An alternate merge conflict resolution 804 is listed below the implemented resolution, specifying the resolution that would have been produced had the legally subsequent revision determined the result. The alternate merge conflict resolution 804 would have retained the legally subsequent revision of changing the license plate to 2QWS944.
  • the user may be allowed 204 to select a merge conflict resolution strategy to resolve the conflicting insurance policy terms.
  • the differences introduced by the new policy data revision may then be reapplied 205 (i.e., re-merged) to the newly-created legally non-overlapping policy data revisions according to the selected merge conflict resolution strategy, to create new merged legally non-overlapping policy data revisions.
  • the re-merge will first delete any existing merged legally non-overlapping policy data revisions and recreate the initial newly-created legally non-overlapping policy data revision.
  • the system will then perform the re-merge based on the user's selected conflict resolution strategy to produce a new set of merged legally non-overlapping policy data revisions.
  • a user may also be able to view the non-overlapping revisions created as a result of merging the new changes forward. Further, the user may be provided with an opportunity to edit 206 a primary revision, wherein the primary revision comprises the merged legally non-overlapping policy data revision having an earliest legally effective date. In the above example, the primary revision is the post-merge version of D1. In addition, the user may be provided with an opportunity to edit 207 the secondary superseding revisions, wherein the secondary superseding revisions comprise the merged legally non-overlapping policy data revisions subsequent to the primary revision. In the above example, the superseding revisions are the post-merge versions of D2 and D3. As shown in FIG. 9, an illustrative screen shot 900 displays a list of effective dates 901, as provided in a dropdown list. Selecting from this list allows a user to switch between revisions and allows the user to view the selected revision.
  • the net set of differences and conflict resolutions can be recollected for display to the user for review before the policy can be quoted.
  • This process is similar to the process of collecting the differences after the merge, except that arbitrary changes may have been made to any of the superseding revisions, including additions or removals of policy elements, or changes to policy data fields.
  • the pair-wise differences must be determined between each superseding revision and the immediately subsequent superseding revision in legally effective time. Therefore, referring again to FIG. 2, differences are determined 208 between the primary superseding revision and a most temporally recent prior policy data revision, and between 209 each secondary superseding revision and an immediately legally subsequent superseding revision. In considering each pair-wise difference, any field-level conflicts between 210 each secondary superseding revision and the immediately legally subsequent superseding revision may then be detected. In addition, any resolutions to the identified conflicts may also be detected 211. Finally, the pair-wise differences and the conflict resolutions are collected together for display 212 to the user.
  • the differences between each of the new revisions (except the last superseding revision) and the bound revision on which it is based are computed.
  • FIG. 10 an illustrative schematic of an insurance policy is shown post-merge.
  • the differences between each of the new revisions (except the last superseding revision) and the bound revision on which it is based are shown as ⁇ 1 605 and ⁇ D2 1001.
  • the differences between each superseding revision and an immediately legally subsequent superseding revision are determined, which are shown as ⁇ 2 1003 and ⁇ 3 1004 in FIG. 10.
  • the differences shown as ⁇ B 608 and ⁇ C 609 in FIG. 10 must be computed, as described above.
  • the differences between D1 and D2 to be displayed to the user are roughly equal to the differences ⁇ 2 1003. However, in the event of merge conflicts, the differences to display to the user may be slightly different from ⁇ 2 .1003.
  • the differences between D1 and D2 may be computed as a function of three sets of differences: ⁇ 2 1003 (the literal difference between revision D1 and revision D2), ⁇ 1 605 (the difference between revision A and revision D1), and ⁇ B 608 (the difference between revision A and revision B).
  • the RIID of the added or removed element can be used as a "key"; additions or removals for elements with different RIIDs may be processed independently.
  • the difference sets ⁇ B 1102, ⁇ 1 1103, and ⁇ 2 1104 are consulted, and their values compared to the corresponding columns of the lookup table 1100.
  • One of the 11 cases must match, and the "Add Diffs" column 1105 shown in the table 1100 is used to determine what change to add to the set of differences displayed to the user.
  • the cases labeled 5A 1106 and 5B 1107 correspond to field-level merge conflicts resolved according to two different conflict resolution strategies.
  • the cases labeled 1 1108, 2B 1109, 3B 1110, 4B 1111, and 5C 1112 occur only because the user has made a manual edit to the superseding revision after the merge.
  • These cases can be identified and displayed specially to the user on the review page, as indicated by the "Conflict Resolution" column 1113.
  • any edited differences introduced by the edited primary superseding revision are first determined 301. This step involves determining the differences between the edited primary revision and the base revision, thereby determining a new ⁇ 1 . Then, the edited differences are applied 302 to the initial newly-created legally non-overlapping policy data revisions to create new merged legally non-overlapping policy data revisions.
  • the differences of the new ⁇ 1 are applied to the initial legally non-overlapping policy data revisions.
  • the re-merge occurs in the same manner as described above for the initial merge. After the re-merge, the policy may then be re-quoted. It should also be noted that if a user had made edits to any of the superseding secondary revisions after the initial merge, those edits will be lost if the user elects to re-merge.
  • each policy data revision may have a corresponding change date (y-axis 404 in FIG. 4) and a corresponding legally effective date (x-axis 403 in FIG. 4) stored therewith.
  • the change dates and the legally effective dates can then be used to facilitate determination of a present liability.
  • the policy data revisions may be queried in terms of a change date to determine a status of the insurance policy as of a queried-for change date.
  • the policy data revisions may be queried in terms of a legally effective date to determine a status of the insurance policy as of a queried-for legally effective date.
  • a user could enter a particular change date or legally effective date and the status of the insurance policy for the entered date would then be displayed.
  • Querying in terms of the change date allows a user to ask what versions existed when looking at the history of the policy from some earlier date. Therefore, a carrier can determine what an insurance policy looked like on an effective date X based on the history at an earlier date Y.
  • a user would use today's date as the change date, however it may be necessary to determine how a policy looked at some time in the past (such as, for example, legal reasons or audits). Therefore, the policy will be queried using a past change date.
  • the insurer will want to know what the policy looked like as of the date that a claim was reported, in order to detect possible fraud where a damaged item is added retroactively to the policy after the damage has actually occurred.
  • each policy data revision has a corresponding change date (y-axis 404) and effective date (x-axis 403). If a user asks what version of the policy is effective on 10/2/05, the user is typically assuming a change date of today and the system should show the user revision D3 503. Therefore, "today" would be the default change date. However, a user may need to determine what policy was in effect at a time earlier than today.
  • the system should show revision C 407.
  • the system should show revision B 406.
  • an illustrative screen shot 1200 shows a list of recent policy transactions.
  • the top portion 1201 of the screen shot display 1200 lists the completed policy transactions, while the bottom portion 1202 displays revisions that are currently in process and have not yet become bound.
  • the first list is sorted by "Effective Date" 1203, with the link associated for each listed date taking the user to the policy file as of that date (current behavior).
  • the linked effective dates such as the date of "01/10/2006" in the first row 1204, are those that are underlined. It should be noted that the effective date of "01/10/2006" in the second row 1205 is not linked because it has been completely replaced by the revision above it that has the same effective date but a later issue date.
  • the final column 1206 lists the "Net Premium" and is intended to show the total transaction amount associated with the quote for that revision. For an OOSE resulting in multiple revision segments (such as the revisions in the first row 1204 and the third row 1207 based on the same work order), each revision has a quote listed in the premium column. Therefore, a user can view the revised policy premium based on each revision.
  • a new OOSE policy data revision may also comprise an unbound draft revision that is not yet an implemented revision.
  • a new policy data revision is 304 a temporally subsequent unbound version as compared to a first policy data revision and also comprises a legally effective date range preceding at least in part an effective date range of the first policy data revision
  • legally non-overlapping unbound policy data revisions may then be created 305 for each legally overlapping effective date range as exists between the new policy data revision and all temporally preceding policy data revisions.
  • a draft revision will not affect any other policy calculations until it becomes bound.
  • the above-described merging forward process can be performed on the legally non-overlapping unbound policy data revisions so that a user may then evaluate the potential effects of this new revision on the policy should it become bound. If the unbound revision is then implemented, the legally non-overlapping unbound policy data revisions will become bound as of a particular change date and effective date.
  • a second unbound OOSE draft revision may be proposed having alternative policy terms.
  • a second new policy data revision is 306 a temporally subsequent unbound version as compared to a first policy data revision and also comprises a legally effective date range preceding at least in part an effective date range of the first policy data revision
  • second legally non-overlapping unbound policy data revisions may then be created 307 for each legally overlapping effective date range as exists between the second new policy data revision and all temporally preceding policy data revisions.
  • the above-described merging forward process can be performed on the second legally non-overlapping unbound policy data revisions so that a user may then evaluate the potential effects of this second new revision on the policy should it become bound.
  • the legally non-overlapping unbound policy data revisions corresponding to the new policy data revision may then be compared 308 to the second legally non-overlapping unbound policy data revisions corresponding to the second new policy data revisions. This comparison can allow a user to determine the potential results produced by each unbound revision and evaluate options based on those potential results. A user may then select the appropriate unbound revision, if any, for implementation so that it becomes a bound revision, while the unimplemented revision may be discarded.
  • FIG. 13 generally depicts pertinent portions of an apparatus 1300 for facilitating policy revisioning.
  • This apparatus 1300 includes generally a first memory 1301, a second memory 1302, a processor 1303, and, optionally, a user interface 1304.
  • the first computer memory 1301 has stored therein data that defines an insurance policy as a plurality of discrete temporally-sequential policy data revisions, wherein each revision incorporates information from temporally prior revisions covering an effective date range of the revision.
  • the second computer memory 1302 has stored therein a program that executes when a given one of the policy data revisions is temporally subsequent as compared to a first policy data revision and also comprises a legally effective date range preceding at least in part an effective date range of the first policy data revision, and creates legally non-overlapping policy data revisions for each legally overlapping effective date range as exists between the new policy data revisions and all temporally preceding policy data revisions.
  • Each newly-created legally non-overlapping policy data revision comprises changes introduced by the new policy data revision and at least one temporally preceding policy data revision.
  • the processor 1303 controls execution of the programmed instructions.
  • a user interface 1304 may be operably coupled to the processor to thereby facilitate obtaining instructions from a user.
  • a variety of user interfaces are available and well-known in the art and may include, for example, a user display and a user input such as a keyboard and cursor control interface of choice.
  • the program stored in the second computer memory 1302 may then determine the differences introduced by the new policy data revision and automatically apply the differences to the newly-created legally non-overlapping policy data revisions. In automatically applying the differences, the program may also determine if the application of the differences introduced by the new policy data revision to the newly-created legally non-overlapping policy data revisions creates conflicting insurance policy terms. The program may then automatically resolve any conflicting insurance policy terms. Further, the program stored in the second computer memory 1302 may then use the legally non-overlapping policy data revisions to calculate a revised policy premium.
  • Each policy data revision stored in the first computer memory 1301 may have a corresponding change date and a corresponding legally effective date.
  • the newly-created legally non-overlapping policy data revisions created by the program stored in the second computer memory 1302 may have a corresponding change date and a corresponding legally effective date that is also stored in the second computer memory 1302.
  • the program may then use the change dates and the legally effective dates to facilitate determination of a present liability.
  • Such an apparatus 1300 may be comprised of a plurality of physically distinct elements as is suggested by the illustration shown in FIG. 13. It is also possible, however, to view this illustration as comprising a logical view, in which case one or more of these elements can be enabled and realized via a shared platform. It will also be understood that such a shared platform may comprise a wholly or at least partially programmable platform as are known in the art.
  • the teachings, as set forth above, provide an advantageous approach to handling of an out of sequence revision by dividing an insurance policy period into time intervals and corresponding revision segments.
  • information regarding the effective date and the actual change date will be retained despite the introduction of an out of sequence revision.
  • insurance providers may accurately process claims and also monitor fraud activities and preserve information for auditing purposes or other legal reasons.
  • the described embodiments provide for an effective and efficient approach for handling insurance policy revisions.

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